Endometriosis of the sciatic nerve.

Endometriosis is a common disease, which affects 5-10% of women in fertile age 1. It can affect multiple organs , such as ovaries, lungs, colon, nasal mucosa and brain 2. Endometriosis of the sciatic nerve is a rare presentation 3 , manifesting as cyclic sciatica, parestesis and pa-resis with loss of deep tendon reflex. We cite a case of sciatica endometriosis and make a review of the literature. CASE A 26-year-old Caucasian woman exhibits intense pain and weakness in the lower left limb, which had progressed over the past nine years. She had no previous pregnancy and symptoms were worse during the men-strual period. During examination, a dorsiflexion paresis of the left foot was notable. Magnetic resonance imagining (MRI) revealed an expansive process in the left sciatic nerve topography at gluteal topography. The patient was referred for microsurgery, proceeding exeresis of a cystic lesion in the left sciatic nerve. Neuropathology analysis showed an endometrioma (Figure). The patient had no complications during the post-operative period. During initial follow-up, dorsiflexion paresis in the left foot persisted. Post-operative MRI showed a cica-tricial process, with no residual tumor. The eletroneu-romiography (ENMG) displayed signs of a subacute de-nervatory process. DISCUSSION Endometriosis is a chronic recurrent pathology, characterized by proliferation of endometrial tissue outside the uterine cavity 4. Typical locations include the ovaries , uterosacral ligaments, pelvic peritoneum, vagina 2. Common clinical presentations are dysmenorrhea, infertility , dyspareunia, dysuria, or it can be asymptomatic. The occurrence of endometrial tissue in the nerve root is a rare location, which was related for the first time in 1946 by Schlicke 5. Cyclic sciatic is a rare symptom of endometriosis. Salazar-Grueso and Roos describe a mean Figure. Hemorrhagic stroma with endometrial epithelium.